David Melson

Healthy talk about health care

Posted Thursday, August 30, 2007, at 7:47 AM
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  • I certainly agree that all physician disciplinary records should be public record. I also think that we should have an avenue available to "rate" doctors on a local level. Sort of like angieslist.com for medical professionals. As for the importing of prescription drugs from other countries goes, if the drug companies weren't trying to fleece the American public simply because we're better off than other countries, then we wouldn't have to do that. If the drug companies can sell a pill to Canada for $0.40, why are they selling the same pill in the United States for $1.40? That's just being greedy.

    -- Posted by Thom on Thu, Aug 30, 2007, at 8:36 AM
  • Given the fact that medical incompetence killed my father nearly 10 years ago, I'm all for point two. In spades. I'd make it harsh.

    -- Posted by Brian Mosely on Thu, Aug 30, 2007, at 8:54 AM
  • *And full discipline records on all physicians should be freely available online.

    Great idea. I'm all for it!

    -- Posted by weezie84 on Thu, Aug 30, 2007, at 11:25 AM
  • Very contentious topic, and very very complex. Here is my take, point by point:

    1. As far as I am concerned, the medicines a doctor prescribes and the treatments he/she recommends are expert advice only. If the patient chooses to accept or decline treatments, or buy drugs from Timbuctoo, so be it - as long as the patient understands the risks, benefits and alternatives.

    2. We all agree that if your car mechanic forgot to replace the drain plug during an oil change and your engine seizes on the way home, he is clearly responsible and should be fired/reprimanded/whatever. The same should apply to professional medical workers, and does...but the problem is how do you decide what is "incompetence or irresponsibility"? Who decides? A jury of folks who know nothing about medicine? A Judge who knows even less? Doctors, who are obviously biased?

    3. The modalities in place currently to inform the public about "bad doctors" is woefully incomplete, to the point of uselessness. One physician can leave surgery to cash a check, get sued and found negligent and pay 5 million dollars. One can work hard to save the life of a drug abusing wife beater who crashed his car going 100 MPH with no seat belt, and loses a leg because of a rare blood clot; get sued and lose because the doc's lawyer didn't put on as good a show in court as the drug abuser's lawyer (whom he doesn't have to pay), have to pay 5 million bucks. Both docs will look exactly the same on the "Healthgrades" sites. Doc number one should certainly be "banned", what about number 2? There is no way any lay person could understand the intricacies involved in medical decision making, any less understand a web site's version of these two stories and how to separate the wheat from the chaff.

    Gotta go to office...will add more later.

    -- Posted by nmonajjem on Thu, Aug 30, 2007, at 2:21 PM
  • First I apologize for the bad grammar above...it should be "...the public about bad doctors ARE woefully...".

    Now, one has to define "discipline records". Is it important to you that your doctor was disciplined because he did not complete his medical records on time? Believe it or not, there are docs out there that have a consistent record of bad outcomes and poor performance that fall below the thresholds currently established for reporting, but a good doctor can lose his privilege to practice at a hospital, and get reported to a National Database, if he does not sign an order he wrote three months ago on a long-ago hospitalized patient - this can easily jeopardize a career.

    Speaking personally, I (and about 90% of all caregivers) continue to do what we do in spite of the constant bureaucracy, threats of lawsuits, onerous regulations, ridiculous financial constraints because we simply love to do it. It is worth it to see a young kid writhing in pain in the ER leave the hospital less than a day later after his appendectomy, feeling well. You may not believe it, but that is what fills the employee parking lot every day at our little hospital in Bedford County...and that is what will be at the new hospital. I wouldn't have it any other way with MY patients.

    -- Posted by nmonajjem on Thu, Aug 30, 2007, at 3:47 PM
  • Here in Alabama, the State Board of Medical Examiners does keep an online datbase of disciplinary actions taken against doctors (I believe in Mississippi too, correct me Dr. M if I'm wrong). The problem I have with most proposed online databases is that it includes legal judgements against the doctor. Med mal is such complex legal issue that many times there is a poor distinction between poor outcome and outright malpractice. Usually this comes down to what is a standard of care for a particular problem. In our current court system, it's juries that establish the standard of care for a locality, not medical peers. Think about that. That guy who dropped out of school at 16 and gets called for jury duty has the power to change the standard of practice for doctors. Yikes.

    I do agree though, medicine is the most fun way to make a living in the world. That's what I've told my daughter many times and I think she may be a premed major at Auburn next year (please, PLEASE don't let it be Alabama :)

    -- Posted by Tim Baker on Thu, Aug 30, 2007, at 6:30 PM
  • I will say this, medical advice is not written in stone. It is simply advice and should be taken as such. That is how I see it anyway. However years ago one of my children was in the local ER (yes I know, that was my first mistake) and when the Dr (who shall remain nameless because I hope he has learned better by now) came in and proclaimed "she has an ear infection and it's pretty bad" I was filled with disgust. Not because of the ear infection but because I was tired of hearing that same old excuse everytime. I was told a week or so earlier by her doctor that when a baby, or anyone for that matter, cries the inside of your ears get red. And what does a baby do when they don't feel good? Thank you. Point made. EVERY SINGLE TIME I have taken any of my kids to the local ER they ALWAYS have an ear infection. Always, and that ear infection always clears up by the next day when they see their doctors. On the one particular night I am speaking of this doctor had the nerve to tell me that if i didn't let him give my baby a shot he was going to call Child Protective Services on me. I gathered our stuff and said "Call them, and while you have them on the phone let them know we have gone to Murfreesboro. They can find me there.". I never heard anything out of CPS but medical advice, is just that. ADVICE. It is not the end all be all. Sometimes Mother's really do know best. What was wrong with her if it wasn't an ear infection you ask? Migraines. Migraines from the Pitocin they used to put me into labor.

    Sorry I got off on a rant, what the new hospital needs in order for me to go is.....NEW DOCTORS!

    -- Posted by sambntn on Fri, Aug 31, 2007, at 9:24 AM
  • "years ago one of my children was in the local ER (yes I know, that was my first mistake)"

    -Posted by sambtn

    This an interesting parenthetical! What are you implying here? Does everyone listening agree with this "mistake" of taking someone to the local ER? If so, based on what? Anonymous details, please! Whom have you told about this besides friends, family, and blogs?

    Speak out folks! Now is the time to have your voices heard about the hospital we ALL call OUR hospital! I am going to crosspost this as an entry in my blog, so you can answer there, too.

    -- Posted by nmonajjem on Fri, Aug 31, 2007, at 12:52 PM
  • It is common knowledge that our hospital is not great, sorry that hurts your feelings or whatever but common knowledge.

    .....off to read your blog.

    -- Posted by sambntn on Fri, Aug 31, 2007, at 3:49 PM
  • It hurts my feelings not at all. As one who strives for improvement on a daily basis, I welcome criticism - however, it needs to be: based on fact, not heresay or "common knowledge", and coupled with constructive recommendations for improvement.

    -- Posted by nmonajjem on Fri, Aug 31, 2007, at 6:09 PM
  • constructive recommendations:

    #1. If you are a doctor in the ER and you see your nurse staff playing with each others behinds, DO NOT join in. Repremand them and send them home if you have to. I have witnessed that first hand.

    #2. If you are a nurse in the ER and you make it your personal mission to be as rude as possible to people who are already iether sick or tired from taking care of a sick person all day DO NOT be suprised when said person snaps and tells you not to come in that particular room until they are gone.

    #3. If you are a doctor in the ER and someone brings their sick child in, look past their ears! It is not always an ear infection.

    #4. If you are a doctor in the ER and someone tells you that because you didn't look past their childs ears to diagnose further they will not be taking ANY of your advise, do not bother calling the police. They had their children in that same ER and you treated them the same way.

    #5. If you are a doctor or nurse in the ER do not act as if you are doing me a favor seeing me. It is your job. You get paid for it. I pay you to see me so drop the holier than thou attitude, it's not becoming.

    I could go on and on but I feel as if it will take years to improve the above 5 reasons that I had rather die of a heartattack on my way to St. Thomas than stop at Bedford County.

    -- Posted by sambntn on Tue, Sep 4, 2007, at 8:07 AM
  • This is a few days late, but I just thought I would chime in.

    The FDA should start doing it's job and stop letting major industries BUY food and drug approval.

    The former Commissioners for the FDA should not be allowed to go to work for those industries after they have been in charge of "scrutinizing" the products and eliminating "potential threats"... The FDA is no better than any other governmental agency that is supposed to protect the consumers, not defend the drug companies...

    Everyone wants to know why America is now less healthy than ever, at the same time fast-food industry and diet drinks products are rampant. Well, if the FDA would just simply do their job and stop taking under the table payments from drug company lobbyists, I am sure that healthcare in America would return to a much better stance when compared to the world.

    -- Posted by darrick_04 on Sun, Sep 9, 2007, at 2:55 PM
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